Prognostic value of XIAP and survivin expression in locally advanced breast cancer patients treated with anthracycline-based neoadjuvant chemotherapy
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1st Department of Surgical Oncology, Copernicus Memorial Hospital, Lodz, Poland
Department of Cancer Pathology, Medical University of Lodz, Lodz, Poland
Department of Hematology, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland
General Oncology Counseling Center, Copernicus Memorial Hospital, Lodz, Poland
Department of Surgical Oncology, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland
Submission date: 2019-05-19
Final revision date: 2019-08-06
Acceptance date: 2019-08-19
Online publication date: 2019-10-07
Arch Med Sci 2023;19(2)
Neoadjuvant treatment in locally advanced breast cancer (LABC) is intended to decrease the cancer mass, increase the likelihood of radical resection and improve survival. Resistance to chemotherapy may depend on cellular expression of anti-apoptotic proteins. XIAP and survivin are the most potent inhibitors of apoptosis (IAP), but their role in drug-induced cancer cell apoptosis remains unclear. This study was designed to evaluate the impact of pre-treatment expression of XIAP and survivin on pathological complete response and survival in LABC patients.

Material and methods:
The study included 60 LABC patients treated with anthracycline-based chemotherapy. XIAP and survivin expression was assessed immunohistochemically in pre-treatment core biopsy specimens.

Pathological complete response was achieved in 33% of the LABC patients. Low/intermediate expression of both XIAP and survivin was significantly associated with pathological complete response (p  0.04 and p < 0.001, respectively) and positively correlated with disease-free survival (p = 0.017 and p < 0.001) and overall survival (p = 0.052 and p < 0.001). The area under receiver operating characteristics curves (AUC) revealed predictive value of survivin expression for relapse and death in breast cancer patients (AUC = 0.63, p = 0.001 and AUC = 0.8, p < 0.001, respectively).

Our findings suggest that downregulation of XIAP and survivin in LABC patients might predict better treatment outcomes after anthracycline-based chemotherapy. This, in turn, may indicate XIAP and survivin proteins as potential targets for innovative anticancer therapies.